Suture package



Dec. 24, 1940. HORNE 2,225,833

SUTURE PACKAGE Filed March 26', 1958 Patented Dec. 24, 1940 UNITED STATES PATENT OFFICE SUTURE PACKAGE Cyrus F. Horine, Baltimore, Md. Application March 26, 1938, Serial No. 198,177

2 Claims.

The invention relates to commercially packaged sterilized sutures, or ligatures, used for stitching and tying in surgical operations, and particularly to an improved suture bobbin for coiling and supporting a length of twisted suture strand.

The prior art constructions have the disadvantages that the strand, which is of catgut, or similar material, which is preserved and maintained in moistened and sterilized condition by means of alcohol, .or other suitable liquid, in which the ligature and the bobbin on which the suture, or ligature, is wound, is submerged in a transparent container which is creased, or other wise adapted to be easily opened, or broken, to release the bobbin.

The various products previously provided for this purpose have the disadvantages that the strand is sharply bent, or creased, and tends to knot, or kink, at numerous points when withdrawn from the bobbin, and the strand is consequently weakened, giving it a tendency to failure in use; also, it is difficult to straighten, and

lacking in facility in unwinding to release thev suture for use in stitching, or tying.

The bobbin and winding method of the invention overcome these difiiculties, and have the advantages that the ligature is easily and quickly withdrawn from the bobbin without kinking, or the formation of knots, that it is easily straightened, and, being wound on a continuous curve, is lacking in the sharp bends, or turns, referred to as imparting weakness to the strand. It is also of interest that in the catgut, which constitutes the suture, and which is generally twisted clockwise in its original preparation, this twist is maintained, and even increased in the winding operation in the product of the invention, the winding being performed in the same clockwise direction in which the ligature, or suture, is twisted. It will be understood that in the practice of the invention, the ligature may be wound to correspond to the twist in whichever direction this may be performed, the direction of winding being the same as the direction of twist.

It is also of interest that the strand may be let off directly from the bobbin for use in the so-called free-hand ligatures, the term freehand ligatures, in this sense, being used to designate the pieces of catgut, or similar strands, which, in the former practice, were generally from 12 to 15" in length, free from the needle and used to tie blood vessels, etc. The Efree-hand ligatures in the prior art practice are of this length, so that a portion of the ligature may be wound around the hand, or fingers, during the act of tying the knot, because the ligature is usually still moist when used, and also it is slippery from fat and tissue fluids.

In the practice of the present invention, the bobbin on which the catgut strand, or ligature, 5 is wonnd, may be held in one hand, and the free endof the strand let off from the bobbin, between the second and third fingers, as the bobbin rotates in the hand. With the bobbin thus anchored in the hand, the thumb and index finger are free for use in the tying of the knot.

A series of 12 ligatures, i. e. lengths for tying, may be thus obtained from a single 60" strand of gut, and this will serve to tie conveniently and efficiently 12 blood vessels, or the like.

Important features of the invention are that the bobbin is in the form of a slender elongated cone, the thickness at the base of the cone depending upon the size of the container in which 20 it is to be packed. For instance, the base of the cone should be /4" in diameter if it is to be enclosed in a glass container having the customary internal diameter of approximately Under these circumstances, the apex ,of the cone, or frustum, the bobbin not actually being pointed in the preferred form, is rounded, and, in the circumstances above related, which are in accordance with the existing practice, should not exceed of an inch in diameter, and would, preferably, be of a little less than this dimension. The average length of the bobbin, according to the existing practice, would be about 2 which length will accommodate a suture strand, or ligature-of approximately 60" .in length. 35

Important advantages .of the tapered bobbin are that the ligature is wound, in the form of a smoothly curved spiral, and is easily released in this spiral form withoutunwinding, and, fur ther, when the strand is drawn taut, and then straightened .from this spiral form, the twist, which is normally placed in the strand, is in creased, avoiding the previously existing tend-' ency to become untwisted, knotted or kinked at points, and flattened-with the resulting tendency 45 to weakness as to these untwisted and/or flattened portions, and a more harmful tendency on the part of the flattened, or untwisted, portions to'cut the flesh in use.

The accompanying drawing illustrates a vcompleted suture package, together with the details of the bobbin and the manner of winding the suture strand thereon, the construction illustrated being regarded as an embodiment of the invention in, the preferred form.

tails of construction. The scale of this figure is 4 times the actual size.

Fig. 3 shows a fragment of suture strand, or ligature, partially straightened from the spiral, and in the form which it would naturally take after being drawn taut, and released. This is shown on a magnified scale.

Fig. 4 is a View similar to Fig. 3, substantiall actual size, showing a longer fragment of ligature which has been straightened by drawing taut, and released.

Referring to the drawing by numerals, each of which is used to indicate the same, or similar parts in the different figures; the construction shown comprisesa glass container l, of the type in general use for this purpose, the container being shown'with its length horizontal. This is a little over half-filled with a liquid of ligature preserving and sterilizing properties, which liquid would, ordinarily, be alcohol. The liquid is indicated by reference character 2.

Within the container is also enclosed a bobbin 3, formed in accordance with the invention, on which bobbin the suture strand, or ligature, 4, is wound, the manner of winding illustrated being in accordance with the preferred practice of the invention. In accordance with this practice, above identified, the bobbin 3 may be referred to as a conical frustum, the slope of the cone being gradual, and the circular base of the cone being of small diameter as'compared to the length of the cone.

In accordance with the preferred details of the practice of the invention, the bobbin would be 2 in length, the suture being approximately 60" long, though the details of dimension are not regarded as of inventive character, or as limiting the scope of the invention in any way.

As already pointed out, the rounded apex of the cone at, 5 is preferably about A; of an inch in diameter, the base of the cone being approximately in diameter, and, in accordance with the scale of proportions, already discussed, the glass should be about in internal diameter to correspond with the existing practice.

In accordance with the preferred proportions inwhich the bobbin has been constructed, the base portion of the bobbin for about three quarters. of its length, has a very gradual taper from the base 6 up to a shoulder 1 beyond which point,

toward the apex 5, the taper is more abrupt,

though the taper is subject to variation, without departure from the spirit of the invention.

Near the base of the cone, the bobbin is perforated at 8 transversely to its axis, and, in the preferred arrangement approximately at right angles thereto. This perforation may be about A,. of an inch in diameter, and may be placed A of; an inch from the base, though these dimensions are not essential. The hole, or perforationt is, to best advantage, countersunk-at each'end at 9, the edge portions, or counter-sinks 9 having a smooth approximately circular curvature, as shown in Fig. 1, in crosssection. Other releasable fastening for the ends may be used.

In accordance with the existing practice, the suture strand, or ligature, is provided with a needle l0 attached thereto at one end, and, in

winding, this needle I0 is passed through the hole 8 in the bobbin and permitted to swing free, being supported by the container as best shown in Fig. 1. The normally twisted suture material or strand is then wound about the bobbin in clock-wise direction, the product, or suture strand, as obtained on the market for this purpose, being ordinarily twisted in a clockwise direction. In winding, each turn of the spiral as at I2, is laid in close relation to the preceding turn 14, and, preferably, each turn is given a further clockwise twist about the axis of the catgut in winding.

This procedure in winding is continued to a point about A, in the preferred practice, from the apex, or small distal end 5 of the bobbin. The free end of the strand, or ligature, is then wound clockwise .by one or two turns back to the perforated end of the bobbin for fastening that end of the string. It is important not to wind the catgut tightly because any considerable tension is undesirable and this method of securing the free end of the strand 15 will permit slight shrinkage or elongation of the coiled suture strand without causing untwisting of the strand at any point.

The distal end I! of the suture, or strand, or ligature as it is sometimes called, is then passed through the hole, or perforation 8 oppositely to the direction in which the. needle is passed through the same hole, so that it emerges on the side of the bobbin opposite to the needle. The bobbin is then inserted in the container, with a suitable amount of preservative antiseptic liquid, as alcohol, and sealed, the practice as to the container, liquid, etc. being already established.

The bobbin may be of wood, glass, fibre, or any other suitable material, and while the practice outlined is particularly applicable to a strand composed of gut, it also applies to various substitutes for this material.

In the use of the suture, the bobbin is first removed from the container, after which the distal end I! of the strand, which is usually of catgut, is withdrawn from the hole 8, and tension applied tothis end of the strand in the direction of the small end of the bobbin, pulls the strand from the bobbin and the needle end is then retracted from; the hole in the base whereby the gut strand, or suture, is entirely separated from the bobbin. This gives a cone-shaped, or spiral strand of suture material, or ligature, the diameter of the spiral decreasing from the base toward the apex, the extreme distal end l1, however, being relatively straight in accordance with the preferred arrangement shown.

The turns of the spiral vary in diameter from the portion of the coil corresponding to the base of the conical bobbin toward the peak portion at 5, the turns being of greatest diameter at the baseyand being more numerous and of smaller diameter, toward-the peak, the relatively short secured outer end portion at l5, being relatively straight. The application of tension to the gut, drawing it to a relatively straight condition, as illustrated in Figs. 3 and 4, thus flattening the coils, increases the amount of twist originally applied to the strand in its manufacture. Any

twist imparted directly to the strand, in winding,

. has a similar and added twisting effect, imparting a twist to any portions of the strand which might, otherwise, have become untwisted.

Such untwisted portions would tend to cut into the flesh in the use of the ligature, and also have a tendency toward failure of the ligature.

Important advantages of the tapered bobbin, and method of winding reside in the preservation and increase of the original twist contained in the suture, or ligature, providing an increase of tensile strength. As above described, the tension applied to the gut spiral to straighten it after it is removed from the bobbin, will tighten the twist in all portions of the strand. It is also of importance that the ligature, or suture coil, has no sharp bends and does not tend to kink, as it is withdrawn from the bobbin.

Further advantages are that the suture material is withdrawn easily and quickly from the bobbin, without unwinding, not only without kinking, but Without any tendency to the formation of knots, and with a consequent saving of time and material.

It is also of interest that the gut strand may be let oif from the bobbin for use in'the socalled free-hand ligatures employed in the tying of blood vessels and the like. In accordance with this practice of the invention, these freehand ligatures may be from 6 to 15" in length, whereas, in accordance with the existing method, it has been necessary to make them from 12 to 15" in length, the short lengths not being usable. This is due to the fact that in the previous types of bobbin, a portion of the ligature must, in the tying of blood vessels, and the like, where freehand ligatures are used, be wound about the hand, or fingers, during the act of tying, not only because the ligature is slippery on account of its moist condition when it comes from the container, but because of the fat and other tissue fluids of the patient.

In the use of free-hand ligatures, in accordance with the invention, the bobbin to which the gut strand is attached, is held in one hand, at right angles to the long axis of the hand, and the free end of the gut is let out between the secnd and third fingers as the bobbin rotates in the hand. With the bobbin thus, anchored in the hand, the thumb and index finger are free for use in the tying of the knot. The economy effected in this way permits a 60" strand to be utilized in the form of 12 free-hand ligatures for 12 separate tying operations, as in closing blood vessels and the like. The ligature is also used for closing wounds by sewing as now practiced.

I have thus described specifically and in detail a single embodiment of my invention in the preferred form, in order that the manner of constructing, operating and using the invention may be fully understood; however, the specific terms herein are used desoriptively rather than in a limiting sense, the scope of the invention being defined in the claims.

What I claim as new and desire to secure by Letters Patent is:

1. In a suture package, a surgical suture and supporting bobbin therefore, the bobbin being generally of conical formation, and the suture comprising a twisted strand wound helically in a single layer thereon and twisted in the direction of the twist while being wound with each convolution about the bobbin in closely adjacent relationship and in which the twist in the suture about its longitudinal axis is uniform about the bobbin from end to end thereof as a result of said last mentioned twist and maintaining a continuous smooth surface throughout the strand.

2. In a suture package, a surgical suture and supporting bobbin therefor, the bobbin being generally of conical formation, and the suture comprising a twisted strand wound helically in a single layer on the conical body thereof with each convolution about the body in closely adjacent relationship and with a uniform twist in the suture strand from end to end thereof and a continuous smooth surface throughout, the bobbin having means at its base end to receive and secure said strand, whereby the suture is supported throughout in the form of a conical coil which may be readily removed over the apex of the bobbin without kinking or bending of the strand or the loss of twist therein.

CYRUS F. HORINE. 

